Meters in the 21st Century

By David Mendosa

If you are still using a 20th century blood glucose meter, it’s time for a new one. Even five years into this new century, our meters are remarkably faster and take much less of your precious blood. They are as small as 3 inches long, less painful, and often available free.

A Great Leap Forward Today

You can get a reading in five seconds using only 0.3 microliters of your blood. Just 10 years ago the standard was 45 seconds and 10 microliters.

The smaller sample size means you can use finer lancets that don’t hurt your fingers as much. Many of the new meters even let you test on alternative sites, like your arms, which have fewer nerve endings causing even less pain.

What we have today is already a great leap forward from April 1968 when an engineer named Tom Clemens applied for a patent on what became the Ames Reflectance Meter. In 1970 another engineer named Dick Bernstein was the first person with diabetes to use a blood glucose meter. Bernstein, who later went to medical school and became a famous endocrinologist, got a blood glucose reading in one minute using a 10 microliter drop of blood — the same amount that was required a quarter of a century later. That meter weighed 3 pounds and cost about $500 or $600.

Our meters today still aren’t noninvasive or continuous. But our new century promises significant advances in our meter future.

At least 38 companies have said at one time or another that they are developing a meter that will be noninvasive. That’s more than all the companies now selling meters in the U.S. Some 13 companies now market their meters to Americans.

The first patent for a noninvasive meter dates from 1976, but no one has yet brought one to market. Spectacular failures like Futrex and Biocontrol Technology emphasize how hard it is to build a noninvasive meter. Still, as I have written here earlier, several excellent prospects are on the horizon. Completely painless blood glucose testing does seem to be near.

Less than half as many companies — some 16 — have announced that they have continuous sensing monitors in development. These monitors are important, especially because they can warn of hypos.

One continuous monitor, the GlucoWatch Biographer, flashed across the meter market. It generated tremendous excitement before sales began in 2002. But, beset with problems, it is no longer made, and its manufacturer, Cygnus, went out of business early this year.

If building a noninvasive or continuous monitor is difficult, how about one that does both? At least five companies say that’s what their meters will do. That would be wonderful, but I’m not holding my breath.

A quarter of a century ago Alfred Mann dreamed of building an artificial pancreas that would include an insulin pump combined with a continuous glucose monitoring system to provide automatic feedback. He created the company that became Medtronic Diabetes, and ever since then an artificial pancreas has been the company’s goal. When that company or another ultimately succeeds, the artificial pancreas will be the blood glucose monitoring system of the 21st century.

This article originally appeared in Diabetes Health, July 2005.

David Mendosa is a freelance journalist and consultant specializing in diabetes and lives in Boulder, Colorado. When he was diagnosed with type 2 diabetes in February 1994, he began to write entirely about that condition. His articles and columns have appeared in many of the major diabetes magazines and websites. His own website, David Mendosa’s Diabetes Directory, established in 1995, was one of the first and is now one of the largest with that focus. Every month he also publishes an online newsletter called “Diabetes Update.” He is a co-author of What Makes My Blood Glucose Go Up...And Down? (New York: Marlowe & Co., August 2003).